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This information is about peripherally inserted central catheters, which are often called PICC lines. They are used to give chemotherapy treatment| and/or other medicines.
A PICC line is a long, thin, flexible tube known as a catheter. It is inserted into one of the large veins of the arm near the bend of the elbow. It is then slid into the vein until the tip sits in a large vein just above the heart.
The space in the middle of the tube is called the lumen. Sometimes the tube has two or three lumens, known as double or triple lumen. This allows different treatments to be given at the same time.
At the end of the tube outside the body, each lumen has a special cap or bung that can be attached to a drip or syringe. Sometimes there is a clamp to keep the tube closed when it isn't in use.
Illustration of a PICC line
View a large copy of the illustration of a PICC line |
Close-up of a PICC line
View a large copy of the close-up of a PICC line image|
The PICC line can be used to give you treatments such as chemotherapy|, blood transfusions|, antibiotics and intravenous (IV) fluids. It can also be used to take samples of your blood for testing. PICC lines can also be used to pass liquid food into the vein if your digestive system is not able to cope with food for any reason. This means that you won't need to have needles put into veins in your arms every time you have treatment.
You can go home with a PICC line in place, and it can be left in for weeks or months. It may be helpful if doctors and nurses find it difficult to get needles into your veins or if the walls of your veins have been hardened by previous chemotherapy treatment. It's also helpful if you don't like needles.
Your PICC line will be put in by a specially trained nurse or doctor in an outpatient department or on the ward. It will be put in using a local anaesthetic.
First, the skin in the area is cleaned with antiseptic solution. Then this area is numbed using a special anaesthetic cream so you don't feel pain while the PICC line is being put in.
When the skin is completely numb, a needle will be inserted and then removed. While the needle is being removed, the PICC line will be threaded through it into a large vein that leads to your heart. This shouldn't take long and is usually painless. The PICC line will be held securely in place by a transparent dressing.
You will then have a chest x-ray to check that the end of the tube is in the correct position.
If your veins are small, it may be difficult to put the PICC line in. Sometimes it can be difficult to thread the PICC line up the vein towards the heart. If this happens, it's usually possible to try again using a different vein.
Sometimes the PICC line seems to go in easily but the x-ray shows it isn't in the right place. If this happens it will be taken out and replaced.
When the line isn't being used there is a slight risk that it may become blocked. To stop this from happening, a small amount of fluid is flushed into the line using a syringe. This is done regularly, usually once a week. The dressing will also need to be changed each week to reduce the risk of infection.
As it's difficult to do this yourself with one hand, the nurses at the hospital may do it for you or arrange for a district nurse to visit you at home. A relative, partner or friend can also be taught to do this if they are happy to.
When you are at home it's safe for you to have a shower or bath with your PICC line in place. Your nurse can give you waterproof covers to stop the line from getting wet.
It is possible for an infection to develop inside the line or in the area where it goes into the vein. You should contact your hospital doctor or nurse if:
If an infection develops you will be given antibiotics. If these don't clear the infection, or if the infection is serious, the line may be removed.
It is possible for a blood clot (thrombosis) to form in your vein at the tip of the line, and you may be given medication to help prevent this. If a clot does form, you will be given some medication to dissolve it and your line may have to be removed.
Signs of a blood clot around the PICC include swelling, redness or tenderness in the arm, chest area or up into the neck (on the same side as the PICC line).
No air may be allowed to get into your PICC line. Not all PICC lines have clamps. Some lines have caps at the end of the lumens that prevent air from entering the line. If your PICC line has a clamp, this should always be closed when the line isn't in use. The line must not be left unclamped when the caps aren't in place.
The PICC line is not secured in place so there is a small risk that it might get pulled out. To avoid the line coming out by accident it should always be taped or covered with a dressing.
It's important that the PICC line is not cut or split. Do not use scissors near the PICC line. It is uncommon to get a cut or split in the line, but in the unlikely event of this happening, contact your hospital immediately, as it may need to be removed if it can't be repaired while still in place.
When you no longer need a PICC line it will be taken out. A nurse will usually do this for you in an outpatient department. It will be gently pulled out. This is a painless procedure that takes only a few minutes.
This section has been compiled using information from a number of reliable sources including:
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